Rapid progress is being made in cancer management with consequent better survival rates, and an increased understanding of the adversities of successsful treatment. Many of these advances have been made within cancer centers, and the swift transfer of new information therefrom to physicians in the community is highly desirable. Centers in turn, rely on the early referral and on follow-up information provided by Community Physicians (CP) in order to continue their advances. This proposal is concerned with the development of programs for the early and full exchange of information between Centers and non-Center-related health professionals so that the latest and best diagnostic, therapeutic and follow-up measures can be shared by patients in Centers and in the Community. Children with cancer simplify such program development because the types of cancer are few, recent treatment successes have been notable and can be attributed to specific therapeutic measures that can be identified. This Center has the Greater Delaware Valley (GDV) Pediatric Tumor Registry as a resource for such a project. The registry is population-based and collects information regarding all children seen at 140 institutions within the GDV. The proposal is divided between two stages: (1) planning (one year) and (2) program development (3 years). The planning period would be employed in convening workshops to which CP would be invited to assist in planning, in assessing the cooperation available for program development, and the feasibility of the methods proposed. The second stage would be phased as follows: (1) a matched case-control study to identify strengths and weaknesses of current patterns of GDV information exchange, (2) a period to devise improvements, (3) implementation of same, and (4) assessment of results. Measures found to be effective for pediatric oncology can be applied to adults as well.